Image Order Form

Please fax or post the completed form to: Photograph Librarian,
Special Collections, Auckland City Libraries, PO Box 4138, Auckland 1036, New Zealand,
Fax 307-7741
Name (Mr, Mrs, Ms)  
Organisation or Business name  
Address  

 
Email Address  
Phone (hm)   (wk)   (fax)  

Official use only

Order No:
To Photographer:

 
Work completed:

 
Contacted:
Staff:

Photographic or Digital Prints

Negative,
issue,
or page
number.

Brief description/caption
date etc..

Gloss or matte

B&W/

sepia/

colour

Print size

Photo, Digital or Laser

No.

of copies
 

 

 

            

Charges
including GST

   

 

 

 

 

 

 

 

 

 

 

 

  
TOTAL    


Receipt No

 
Invoice No

 
Staff

 

Digital Files

Negative,
issue,
or page
number.

Brief description/caption/date etc..

JPEG or TIFF

Emailed or
CD copy
 

 

      

Special instructions:
 

 

 

Please indicate your requirement by selecting one of the following:
  These photographs/items are for my personal use only and are not for further reproduction.
  These photographs/items are required for further reproduction.
NB: The Library requires application to be made for permission to reproduce items from its collection.
Applications must be made on the Application for Reproduction Rights form

 

Signed

 

 Date

April 2004